Chung Hing Cup 2017 (wmhy)
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ANS Shatin 10K Classic Riverside Race 2017 (Manstar)
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Standard Chartered HK Marathon 2017 (wmhy)
Fat Choi Run 2017 (Meimei Chan)
Fat Choi Run 2017 (Meimei Chan)

Pre-participation Evaluation

Has anyone done a pre-participation evaluation/body check before?

As I am trying to race more competitively. However, starting runnung at around 35, I am conscious of my age. Recently, I saw my heart rate spiking during a race, as much as I think the sensor is low on battery, it was a wake up call.

Anyone has any recommendation? I found one online and before talking (with the nurse) long I was asked to have a CT scan and the bill is close to 8000! Does it sound right?

Re: Pre-participation Evaluation

From my perspective, 35 sounds young not old!

When you say your heart rate spiked during a race, that is exactly what it is supposed to do. In a 5K, you should expect to be racing at around 95% of maximum heart rate, in a 10K at 90% plus and in a marathon at about 75% to 80%. I recognise that if you are not used to it, running at these intensities can feel uncomfortable. But if you are serious about running more competitively as you say, you will need to learn to tolerate this sort of discomfort. It will never become pleasant but you can learn to adapt to it with training.

It would be a different matter if what you experienced was arrhythmia, or a highly irregular heart-beat. But if it is just a question of feeling discomforted by an elevated heart-beat, I would success you save your 8,000 and start to introduce some speed work into your training so you can get used to different intensities.

Re: Pre-participation Evaluation

Thanks for your advice.

I train with a group of kids in thier 20s (some with HK ranking). So speed work is there from short sprints to 800m~1km interval trainings, not that I am ever the same pace as the guys, maybe the slower junior girls. However, I see where you are getting at on tolerating stress.

My concern is that I have never seen 200+bpm. 180 is already the highest I have seen in race condition. I still suspect my sensor is out of battery and think the 8000 is a ripoff. I will get some second opinion from other docs but more likely to do the checkup bit by bit and avoid what is not necessary.

Happy running!

Re: Pre-participation Evaluation

In addition to stephen's reply I would say that sometimes heart rate monitors can be deceptive, by taking short time readings and extrapolating these there can be unusual results.

As per above, running by feel is a reasonable guide. There is a difference between uncomfortable and pain; uncomfortable, even extreme discomfort, is normal in a race environment and I think most runners have been through this. Pain is different, if you are injured it is often good judgement to stop.

Re: Pre-participation Evaluation

I think this might interest you:

I recommend these tests to all my friends who are serious about their running/biking. Look for Glen and he'll give you all the details of the tests.

Btw. their price is REALLY reasonable!

Re: Pre-participation Evaluation

This is a difficult subject. My view as a runner for fun/fitness (ie non-competitive).

The evaluation is meant to pick up underlying asymptomatic heart diseases, including cardiomyopathy, coronary heart disease and arrhythmia, that may cause sudden cardiac death during strenous exercise.

What is needed depends on your age, health background, and presence of symptoms and signs.

It may include:

Medical History and Exam:
Family History: any sudden death or coronary heart disease at relatively young age (<60 yo) or hereditary heart conditions
Symptoms: episodes of chest discomfort, palpitation, or faintedness at rest and during exertion
Physical exam: blood pressure, irregular heart rate, heart murmur

Basic tests
ECG at rest: seldom useful. It may pick up cardiomyopathy or ectopics. If you can run a 10K, you are unlikely to have coronary heart diseas that shows up on a resting ECG.
Chest X-ray: cardiomyopathy may show up as an enlarged heart

Advanced tests
Exercise Stress Test/Treadmill ECG: during the test, early coronary heart disease will show up as abnormal ECG during strenous exercise

24 hour ambulatory ECG (Holter monitoring): useful for detecting arrhythmias which may cause episodes of palpitation and faintedness

Echocardiography: ultrasound of the heart Will show enlarged heart and abnormal heart valves and muscle

Coronary CT: this will show hardening and narrowing of the coronary arteries in coronary heart disease. Most individuals do not have any chest pain until coronary arteries are narrowed > 75%. This "definitive" test is used to rule out coronary heart disease.

In your case, coronary heart diseas is extremely unlikely (if you are < 50 yo, no family history of young coronary heart disease). The yield of Treadmill ECG and Coronary CT will be extremely low.

Your concerns will be hereditary heart disease such as cardiomyopathy and arrhythmia. For the episode of fast heart rate > 200 on the heart rate monitor. Did you feel any palpitation or faintedness? Do you feel palpitation in other situations? If you are concerned, a medical history and examination plus an ECG will be worthwhile initial tests.

Incidentally, the VOmax test is useful to test how fit you are. It is used to track improvement in elite or professional athelets. Not meant to test for coronary heart disease or how unfit you are.

Re: Pre-participation Evaluation

Wow this is amazing!!

For the "episode of 200+bpm", I didn't feel anything strange. The load was not harder than my interval trainings (which my heart rate would be around 170~175 max). Therefore, my believe that the sensor is out of battery and hence acting strange.

My grandpa died from heart attack, my dad is also heart attack prone BUT he eats whatever and does no exercise what so ever.

VOmax and those other tests have been my interest, too. That is only at some stage in the future when I am actually closer to 40min, or sub 40m, for my 10km and when I am not improving. So still useful information.